Most cases of ankylosing spondylitis begin with pain in the lumbosacral region. Ankylosing spondylitis is a chronic inflammatory disease that affects the sacroiliac joints and the soft tissues of the spine and spinal column. The pain usually starts in the lower back, which is an early symptom, but can also involve the sacroiliac area, buttocks, or groin. The pain worsens at night when resting or when sitting for a long time, and is relieved by activity. Morning stiffness and spinal rigidity and discomfort may occur, which is relieved by activity. As the disease progresses, swelling and pain in peripheral joints, such as hip, knee, shoulder and ankle joints, may occur. Ankylosing spondylitis should be treated by a rheumatologist as soon as possible and appropriate treatment should be taken as prescribed by the doctor.